Wed10November0747AM 6

In muscular dystrophy:

True / False

Hyperkalaemia and myoglobinuria may occur post-operatively Correct

A pre-operative 12 lead ECG is required Correct

Post-operative chest infections are common Correct

Patients quickly develop tolerance to opioid analgesics Correct

Plasma creatine kinase concentrations will be low Incorrect answer selected

Explanation

Muscular dystrophies are rare hereditary disorders of muscle. Progressive destruction of skeletal and cardiac muscle occurs by a mechanism thought to involve abnormal muscle membrane function. Plasma creatine kinase level may be increased.

Patients tend to present with limb contractures.

They have weak respiratory muscles which impairs ventilation and sputum clearance. Pre-existing and post-operative chest infections are common and they are especially sensitive to opioids and other respiratory depressant drugs.

Severe hyperkalaemia and myoglobinuria may occur following prolonged exposure to volatile anaesthetic agents, therefore regional techniques are preferred.

As arrhythmias and cardiac failure may occur due to myocardial involvement, an ECG and echocardiogram will provide valuable pre-operative information on cardiac function.

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Average score: 89.03%

Times answered: 268